The second night is probably the most challenging for the new mother. Look at it from a physiological point of view. The firs 24 hours require a mother to be more alert so if the baby vomits she will wake and respond. The endorphins from labour prevent her from having a deep sleep in the ifrst 24 hours. At the other extreme is the baby who is generally quiet during the first 24 hours waking and giving eye contact instead of crying in the first 24 hours as an indicator that food is needed. In the first 24 hours this baby is generally peaceful as he/she is recovering from the change in her/his world ie learning to maintain his/her temperature, breathing consistently and also feeding. Now at 24 hours of age (generally at night - the normal fetal active time) he / she wakes up and is lonely and probably scared and needs the security of being cuddled and fed to reassure him that he/she is safe. This night is rugged on the woman. Its only in Western society where a woman is alone during the night and expected to be the primary carer unsupported that we have such dramatic maternal exhaustion. 

We have opened our visiting hours up fully in our unit ie from 9am - 8pm. This has been done for a variety of reasons, the main one is the rudeness of visitors when we "wouldn't let them in". The result is that it is more relaxed on our ward (50 beds) because instead of a mass influx the majority of visitors, the women have a more paced load of visitors.  We spend more time explaining to the women that wakefulness on the second night is the baby going through a major adjustment in life and that they can help the baby by resting during the day (Ha Ha) and expecting the baby to wake that night and simply feeding and cuddling. Plus we reassure them that the  quality of the sleep they have will be deeper because of the impact of the prolactin from the feeds. I find being positive and helping them to get sleep in the morning does help.

Gwen Moody
IBCLC 
WEstmead Hospital, NSW Australia

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